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![Page 1: THE EFFECT OF MUSİC ON THE COMFORT AND ANXIETY OF THE ELDERLY LIVING NURSING HOME Research Asst. Eda Yaşar Manisa Celal Bayar University Dept. of Fundamentals.](https://reader036.fdocuments.net/reader036/viewer/2022062314/56649e6b5503460f94b6a034/html5/thumbnails/1.jpg)
THE EFFECT OF MUSİC
ON THE COMFORT AND
ANXIETY
OF THE ELDERLY LIVING
NURSING HOME
Research Asst. Eda YaşarManisa Celal Bayar University
Dept. of Fundamentals of NursingAsst.Prof. Şebnem Çınar Yücel
Ege UniversityDept. of Fundamentals of Nursing
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The importance of music therapy and
its effects on patients’ recovery was emphasized
by Florence Nightingale in the 19th century,
and recognized as a nursing approach
which reduces
pain and anxiety
and increases a patient’s comfort.*Khorshıd L. Akın E. (2007). Mekanik Ventilatöre Bağlı
Hastalarda Anksiyete Yönetiminde
Müzikle tedavinin Yeri.
Yoğun Bakım Hemşireliği Dergisi; 11(2):83-88.
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Comfort,
which includes relief,
achieving tranquility and the ability to overcome problems,
is a subjective concept.
One way of making this concept
as objective as possible is the ability to measure it.
Bekiroğlu, T. (2011). Klasik Türk Müziğinin Hipertansiyon Hastalarının Kan Basınçlarına Ve Anksiyete Düzeylerine Etkisi,
Gaziantep Ü. Sağlık Bilimleri Enstitüsü, Yükseklisans Tezi, Gaziantep.
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According to Kolcaba’s Comfort
Theory, nurses identify the comfort
needs of individuals in a stressful
health care environment, and
implement nursing approaches to
increase comfort concerning unmet
needs, evaluating the extent to which
they achieve the result of eliminating
anxiety or reducing it to a minimum. *Karabacak, Ü. (2004). Meme Kanserli hastalarda Konforu Destekleyici
Hemşirelik Bakımının Ve Eğitiminin Radyoterapi Uygulaması ile
Etkileşimi, İ. Ü. Sağlık Bilimleri Enstitüsü, Doktora Tezi, İstanbul.
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Anxiety
can be seen as
one of the basic human
emotions.
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Nurses,
who are in constant contact with
the residents of old people’s
homes, will naturally act as
guides to the old people in
reducing anxiety levels and
increasing comfort.
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Examining the literature:
We found studies of the use of music with patients
in intensive care units and various clinics in the hospital environment,
but we came across no studies examining
the effects of music on comfort and anxiety specifically on the
residents of the elderly living nursing home.
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AIM
To examine
the effect of music on the residents
of the elderly living nursing home.
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MATERIALS & METHODS
TYPE OF RESEARCH
This was a randomized controlled
experimental study, with pre-test, post-test
and a control group
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LOCATION AND DATE
The study was
conducted at an Izmir
Municipality old people’s
home between
15 December 2013 and
15 May 2014.
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POPULATION AND SAMPLE
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Inclusion criteria were:
• Being over the age of 60
• Literate
• Turkish-speaking
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Having normal cognitive functions (Standardized Mini-
Mental Test – SMMT):0-12: severe
13-22: medium
23-24: slight
25-30: no cognitive disorder
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Not having been exposed to
environmental factors
(three or more people living in one room,
heat, light, noise)
thought to affect
the comfort of old people
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Not having recently suffered
an attack
of a chronic illness
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• Not having suffered
an acute illness such as flu
in the past three days
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Showing normal vital signs
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Not having a diagnosis of
• Parkinson’s,
• Alzheimer’s,
• dementia or
• major depression.
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RANDOMIZATION
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OLD PEOPLE FITTING THE STUDY CRITERIA
FEMALE
AGE
60-74
AGE
75-89
MALE
AGE
60-74
AGE
75-89
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A total of 208 old people were excluded from the study.
Diagnosed with Parkinson’s, Alzheimer’s, dementia or major depression (n=5)
Not having normal cognitive functions according to the Standardized Mini-Mental Test (n=5)
Having a hearing problem (n=3)
Recently experiencing an attack of a chronic illness (n=2)
Exposed to negative environmental factors (more than three in a room, heat, light, noise) (n=180)
Withdrawing from the study because of problems with record-keeping during the application (n=8)
Not wanting to take part in the study (n=5)
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Of the 264 residents of the old people’s home:
56 people
were included in the study and formed the
research sample –
28 in the experimental group and 28 in the
control group.
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DATA COLLECTION
«An Old People’s Identification Form»
with seven questions
to collect characterization information on the residents of the
home(age, gender, marital status, education level, known illnesses, regularly-used medications, length of stay in the home)
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Anxiety levels were measured
with the 21-item
Beck Anxiety Scale developed by Beck et al.
(1988) and tested for validity and reliability in
Turkey by Ulusoy et al. (1988).
A higher total score shows higher anxiety levels.
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The old people’s comfort levels
were measured using a
General Comfort Scale
(with 48 items,
24 containing positive statements and
24 with negative statements),
developed by Kolcaba in 1992 and tested for validity and reliability by Kuğuoğlu &
Karabacak (2004).
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DATA COLLECTION
*Lai, H.L., Good, M. (2005). Music İmproves sleep quality in older alduts. Journal of ADVENCED Nursing, 49(3):234-244.
The old people were monitored for 22 days
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The control group received no intervention.
On the first day the identification form was applied.
On days 1, 8, 15 and 22, the Beck Anxiety Scale and the General Comfort Scale were applied.
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In the experimental group
On the first day,
the identification form, the Beck Anxiety Scale and
the General Comfort Scale were applied before the
application of music.
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An expert music teacher was consulted to determine
music which would be restful for the old people,
and a piece of
Turkish classical music (Nihavend makamı)
was chosen for its relaxing effect.
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30 minutes of music was played to
the experimental group
between 20:00 to 22:00
for 22 days.
On days 8, 15 and 22,
the General Comfort Scale and the Beck Anxiety Scale were applied.
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Examining the relevant literature,
it was seen that music had been played to
this age group for
periods of 25-30 minutes.
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In the literature,
music had been played to old people
between 20:00 and 22:00, as the most
suitable time, after they had completed
activities such as shopping or eating supper.
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• In order to provide motivation and to make
the experience more memorable, daily
plans were used with the old people Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7Week 1 I listened
to musicI listened to music
I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
Week 2 I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
Week 3 I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
I listened to music
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Dependent and Independent Variables
Dependent variables:
The old people’s total
mean scores on the
Beck and Comfort
Scales
Independent variables:
The old people’s age,
gender, marital status,
education level and
chronic illness;
environmental factors and
music.
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EVALUATION OF STUDY DATA
The difference between groups by week
was examined with
the Mann-Whitney test,
and the difference between total
mean scores between weeks was
examined with Least Significant
Difference (LSD) analysis.
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ETHICS
• The study was performed in
accordance with ethical
principles
• Written permission was
obtained from the Nursing
Faculty Scientific Ethics
Committee
• and informed consent was
obtained from all participants
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FINDINGS
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Total Mean Score Distribution of Experimental and Control Groups
on General Comfort Scale by Weeks
A statistically significant difference was found
between
total mean scores on the General Comfort Scale
of old people
in the experimental group by weeks
(χ2=30.558, p=0.000).
WEEKSExperimental
GroupX ±Ss
Week 1 3.19±0.38
Week 2 3.23±0.32
Week 3 3.40±0.27
Week 4 3.58±0.25
χ2=30.558,
p=0.000
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Total Mean Score Distribution of Experimental and Control Groups on
General Comfort Scale by Weeks
WEEKSControl GroupX ±Ss
Week 1 2.97±0.30
Week 2 3.01±0.33
Week 3 3.08±0.32
Week 4 3.09±0.43
χ2=5.033,
p=0.169
No statistically significant difference was found
between
total mean scores on the General Comfort Scale
of old people in the control group by weeks
(χ2=5.033, p=0.169).
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The differences between weeks of the mean total Comfort Scale score
of the experimental group were examined.
No significant difference was found in Weeks 1 and 2, but a significant difference was found between Weeks 3 and 4
(p<0.05).
There was a significant difference between Week 2 and Weeks 3 and 4 (p<0.05),
and a statistically significant difference was also found between Weeks 3 and 4 (p<0.05).
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In the control group:
No significant difference was found between Week 1
and Weeks 2, 3 and 4 (p>0.05),
no significant difference was found between Week 2
and Weeks 3 and 4 (p>0.05),
and no significant difference was found between
Weeks 3 and 4 (p>0.05).
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Distribution of Total Mean Scores on the Beck Anxiety Scale of the Old People
in the Experimental and Control Groups by Weeks
WEEKS Experimental GroupX ±Ss
Control GroupX ±Ss
Week 1 14.60±12.23 13.67±8.91Week 2 11.42±9.98 12.64±7.84Week 3 6.78±5.19 13.32±9.53Week 4 3.57±4.59 11.32±8.13
χ2=42.416,
p=0.000
χ2=4.601,
p=0.203
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Distribution Of Differences Between Weeks Of Total Mean Scores On The Beck Anxiety Scale
Of Old People In The Experimental And Control Groups
WEEKSExperimental
Group
BAÖ
X ±Ss
p
Control
Group
BAÖ
X ±Ss
p
1. Week2. Week -2.863 0.004 -1.084 0.278
3. Week -3.578 0.000 -0.293 0.770
4. Week -4.200 0.000 -1.531 0.126
2. Week 3. Week -2.649 0.008 -0.527 0.598
4. Week -4.115 0.000 -1.309 0.191
3. Week 4. Week -3.612 0.000 -1.861 0.063
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DIFFERENCES BETWEEN WEEKS IN THE TOTAL MEAN BECK SCALE SCORE
IN THE EXPERIMENTAL GROUP
A significant difference was found between Week 1 and Weeks 2, 3 and 4 (p<0.05),
a significant difference was also found between Week 2 and Weeks 3 and 4 (p<0.05),
and a statistically significant difference was found between Week 3 and Week 4 (p<0.05).
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In The Old People In The Control Group
• No significant difference was found between Week 1 and Weeks 2, 3 and 4 (p>0.05),
• No significant difference was found between Week 2 and Weeks 3 and 4 (p>0.05),
• And no significant difference was found between Week 3 and Week 4 (p>0.05).
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Total Mean Scores On The Beck Anxiety Scale
Of The Experimental And Control Groups By Weeks
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RESULTS
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ACCORDING TO THE FINDINGS OF THE STUDY:
Music
increased comfort and
decreased anxiety levels
in the old people in the
experimental group
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But
no significant change was seen in comfort or anxiety levels among
old people
in the control group (p>0.05).
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In studies on music therapy
*Davis, C., Cunningham, S. G. (1985). The physiologic responses of patients in the coronary care unit to selected music. Heart and Lung .14(6):291-92.Hatem, T. P., Lira, P. I., Mattos, S. S. (2006). The therapeutic effects of music in children following cardiac surgery. J Pediatr (RioJ);82(3):186-92.
Lee, O. K., Chung, Y. F., Chan, M. F., Chan, W. M. (2005). Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs; 14:609-20.
Ovayolu, N., Ucan, O., Pehlivan, S. (2006). Turkish classical music decreases patients’ anxiety, pain, dissatisfaction and dose of and analgesic drugs during colonoscopy: A prospective randomized controlled trial. World J Gastroenterol; 14;12(46):7532-6.
Wong, H. L., Lopez-Nahas, V., Molassiotis, A. (2001). Effects Of music therapy on anxiety in ventilatordependent patients. Heart Lung; 30: 376-387.Vizeli, M. (2010). Koroner Anjiyografi Uygulanacak Hastalarda Müzik Terapisinin Anksiyete Düzeyine Etkisi,
Haliç Üniversitesi Sağlık Bilimleri Enstitüsü ,Yüksek Lisans Tezi, İstanbulYıldırım, S., Gürkan, A. (2007). Müziğin, Kemoterapi Yan Etkilerine Ve Kaygı Düzeyine Etkisi, Anadolu Psikiyatri Dergisi ; 8:37-45.
**Besel, J. M. (2006). The Effects Music Therapy On Comfort In The Mechanıcally Ventılated Patıent In The Intensıve Care Unıt. A Thesis Submitted İn Partial Fulfillment of the Requirements For The Degree of Master of Nursing, Montana State Universty, Montana.
Bekiroğlu, T. (2011). Klasik Türk Müziğinin Hipertansiyon Hastalarının Kan Basınçlarına Ve Anksiyete Düzeylerine Etkisi, Gaziantep Ü. Sağlık Bilimleri Enstitüsü, Yükseklisans Tezi, Gaziantep.
Çiftçi, H. (2011). Müziğin Yoğun Bakım Ünitesinde Serebro Vasküler Olay Tanısıyla Yatan Hastalarda Konfor, Anksiyete Ve Ağrıya Etkisinin İncelenmesi, Çukurova Ü., Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, Adana.
Elliott, D. (1994). The effects of music and muscle relaxation on patient anxiety in a coronary care unit. Heart Lung. 23(1):27-35.Tsay, S. L., Wang, J. C., Lin, K.C., Chung, U. L. (2005). Effects of acupressure therapy for patients having prolonged mechanical ventilation support. J Adv Nurs; 52:142-50.
it has been found that music has the effect of reducing the anxiety levels*
and increasing the comfort levels**
felt by patients.
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However, a scan of the literature shows that
* Yıldırım, S., Gürkan, A. (2007). Müziğin, Kemoterapi Yan Etkilerine Ve Kaygı Düzeyine Etkisi, Anadolu Psikiyatri Dergisi ; 8:37-45.Wong, H. L., Lopez-Nahas, V., Molassiotis, A. (2001). Effects Of music therapy on anxiety in ventilatordependent patients. Heart Lung; 30: 376-387.
Vizeli, M. (2010). Koroner Anjiyografi Uygulanacak Hastalarda Müzik Terapisinin Anksiyete Düzeyine Etkisi, Haliç Üniversitesi Sağlık Bilimleri Enstitüsü ,Yüksek Lisans Tezi, İstanbul.
Ovayolu, N., Ucan, O., Pehlivan, S. (2006). Turkish classical music decreases patients’ anxiety, pain, dissatisfaction and dose of and analgesic drugs during colonoscopy: A prospective randomized controlled trial. World J Gastroenterol; 14;12(46):7532-6.
Lee, O. K., Chung, Y. F., Chan, M. F., Chan, W. M. (2005). Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs; 14:609-20.
Tsay, S. L., Wang, J. C., Lin, K.C., Chung, U. L. (2005). Effects of acupressure therapy for patients having prolonged mechanical ventilation support.
J Adv Nurs; 52:142-50.Khorshıd L. Akın E. (2007). Mekanik Ventilatöre Bağlı Hastalarda Anksiyete Yönetiminde Müzikle tedavinin Yeri.Yoğun Bakım Hemşireliği Dergisi;
11(2):83-88.
other studies on music therapy have
generally been conducted in
intensive care units and on
hospitalized patients*
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Previous studies*
*Davis, C., Cunningham, S. G. (1985). The physiologic responses of patients in the coronary care unit to selected music. Heart and Lung .14(6):291-92.Hatem, T. P., Lira, P. I., Mattos, S. S. (2006). The therapeutic effects of music in children following cardiac surgery. J Pediatr (RioJ);82(3):186-92.
Lee, O. K., Chung, Y. F., Chan, M. F., Chan, W. M. (2005). Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: a pilot study. J Clin Nurs; 14:609-20.
Ovayolu, N., Ucan, O., Pehlivan, S. (2006). Turkish classical music decreases patients’ anxiety, pain, dissatisfaction and dose of and analgesic drugs during colonoscopy: A prospective randomized controlled trial. World J Gastroenterol; 14;12(46):7532-6.
Wong, H. L., Lopez-Nahas, V., Molassiotis, A. (2001). Effects Of music therapy on anxiety in ventilatordependent patients. Heart Lung; 30: 376-387.Vizeli, M. (2010). Koroner Anjiyografi Uygulanacak Hastalarda Müzik Terapisinin Anksiyete Düzeyine Etkisi,
Haliç Üniversitesi Sağlık Bilimleri Enstitüsü ,Yüksek Lisans Tezi, İstanbulYıldırım, S., Gürkan, A. (2007). Müziğin, Kemoterapi Yan Etkilerine Ve Kaygı Düzeyine Etkisi, Anadolu Psikiyatri Dergisi ; 8:37-45.
Besel, J. M. (2006). The Effects Music Therapy On Comfort In The Mechanıcally Ventılated Patıent In The Intensıve Care Unıt. A Thesis Submitted İn Partial Fulfillment of the Requirements For The Degree of Master of Nursing, Montana State Universty, Montana.
Bekiroğlu, T. (2011). Klasik Türk Müziğinin Hipertansiyon Hastalarının Kan Basınçlarına Ve Anksiyete Düzeylerine Etkisi, Gaziantep Ü. Sağlık Bilimleri Enstitüsü, Yükseklisans Tezi, Gaziantep.
Çiftçi, H. (2011). Müziğin Yoğun Bakım Ünitesinde Serebro Vasküler Olay Tanısıyla Yatan Hastalarda Konfor, Anksiyete Ve Ağrıya Etkisinin İncelenmesi, Çukurova Ü., Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi, Adana.
Elliott, D. (1994). The effects of music and muscle relaxation on patient anxiety in a coronary care unit. Heart Lung. 23(1):27-35.Tsay, S. L., Wang, J. C., Lin, K.C., Chung, U. L. (2005). Effects of acupressure therapy for patients having prolonged mechanical ventilation support. J Adv Nurs;
52:142-50.
(despite differences in sampling and methods)
support the findings of our study.
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RECOMMENDATIONS
Turkish classical music can be played to old people to help to reduce their anxiety levels and increase their comfort.
Nurses working in old people’s homes can make use of this effect and include it in their nursing practice.
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Questions, suggestions and contributions to:
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THANK YOU